Issue #4
January 13, 2023

Digest

The Pulse of Oncology Compass

Do medical
congresses
have a future?

The impact of conferences on improving cancer care and how oncologists collect new information during their daily work
EditoriaL

The Value of Oncology Compass for RCC treatment

I consider the work of my colleagues and me on Oncology Compass vital in facilitating the most important developments in the field of Renal Cell Carcinoma (RCC).

RCC has become one of the fastest evolving solid tumour entities in the field of oncology with continuous drug approvals in the last years, making this disease attractive for clinical research and trial designs. The enormous research output from international meetings and publications during the last few years must be reviewed and correctly interpreted by specialists in the respective fields, with a focus on the impact of these data on potential changes of current standards in daily clinical practice.

I am delighted to be part of the scientific board members of Oncology Compass, taking part at the major international meetings where the most recent developments in RCC treatments are presented and additionally immediately discussed with other highly experienced RCC experts.

With the right selection and distribution of practice relevant landmark trials in RCC to the oncology community of treating physicians, treatment selections within the wide range of drugs and drug combinations approved or in development in RCC will certainly be easier and more accessible.
PD Dr. Ursula Vogl
MBA, IOSI Bellinzona
From Basel to Nazareth
From Basel to Nazareth: Oncologists’ Daily Need for Vital Info
Roland Schäfli
Interviewer, Head of Content at Capptoo AG
All over the world, oncologists face the responsibility to stay updated in a rapidly evolving field. We asked two oncologists who work 2500 miles apart: Which sources of new information do you use in your daily work?

Dr. med. Thomas Schmid

Senior Physician Oncology, Adm. Head of the palliative care unit, St. Clara Hospital, Basel, Switzerland
Dr. Schmid, where do you see the greatest need for information in your day-to-day work?
Oncology is a field that is developing rapidly. While certain tumours in different patients used to be treated with the same chemotherapy, today, thanks to molecular diagnostics, it is possible to detect mutations in the tumour and often treat them in a targeted manner. This is of course very gratifying. There are constantly new findings from studies and the resulting new therapy options. Putting this valuable knowledge into practice is challenging.
Can you find enough time to study new information in your daily routine?
In everyday clinical practice, time is often short. However, I think it is very important to take the time to read up on the new information. For me, the exchange with colleagues from oncology is very valuable. During the pandemic, congresses were mostly held virtually. I think it's much nicer that there are now more on-site events again.
How can we visualize this exchange within the oncology department of the Claraspital?
Our oncology department has twelve Senior physicians, two Senior physicians in hematology and three further training assistant physicians. We see each other several times a day during the reports and also at lunch, where informal exchange is possible. All of our patients are discussed at interdisciplinary tumour boards, which take place almost every day. We also hold an oncological therapy meeting once a week in order to discuss individual complex cases in depth. As part of these discussions, there is always the opportunity for updates and for information on new therapy options that have just been announced. Our "Journal Club" is another forum for highlighting and critically discussing current scientific publications.
So you can set aside enough time for your continuing development?
Continuing education is very important to us. We receive at least five training days per year in order to take part in oncological congresses. We regulate participation in the congress in the annual planning. The team members who have attended a congress also have the task of bringing the information collected back to the team.
Which particular congresses or studies would you like to have summarized information from that is available quickly?
For me, the well-known congresses of ESMO and ASCO are among the most important congresses. The organ-specific congresses are also relevant. At these congresses, the "practice changing studies" are presented.
“There are constantly new findings from studies and the resulting new therapy options. Putting this valuable knowledge into practice is challenging.”
With this wealth of information, where else would you need it?
Hardly a week goes by in which no relevant new study is published. In order to keep an overview, especially with tumors that I treat less often, for example, short summaries of practice-relevant studies would be valuable for me.
What question do you hear the most in your work as an oncologist?
A frequent question I am asked by patients who have received a non-curative cancer diagnosis is about the prognosis: "How long do I have to live?" Although we can rely on studies with mean values and statistics, it is not possible to transfer this to the individual patient. I explain this in each case and say that I can't make any precise statements about the time, because I simply don't know.
And in your private life?
A question that people around me often ask is whether we could now cure cancer. The public does not fail to notice that research is making a lot of progress. Nevertheless, I must basically negate this. Fortunately, however, we have many new approaches and promising therapies in oncology, such as the new immune checkpoint inhibitors or targeted therapies. In the case of metastatic tumours, this can often prolong life and improve quality of life.
How did you find the Oncology Compass?
I came across it on LinkedIn. I'm excited about the further development of the platform and look forward to regular study summaries.

Dr. med. Ilit Turgeman

Head of the early-onset cancer service at Emek Medical Center, Afula, Israel
Dr. Turgeman, where do oncologists have the greatest need for information in their daily work?
It is our responsibility to stay updated on the latest evidence-based management paradigms, while at the same time to tailor treatment to each patient, to each cancer. The "art of oncology" to me, is a type of harmony in our daily work; it involves a proficiency in scientific research and the ability to translate it simultaneously to the bedside, to our patients. As oncologists, we work in a rapidly evolving field. We need information for clinical decision-making, in choosing the most effective treatments, in modifying protocols for real life situations, and in selecting appropriate tests and technologies to improve patient quality of life and survival.
Which sources do you use the most yourself, and are you able to take the time to study new information?
Studying new information is a priority for me as an oncologist. I utilize resources made available by international societies such as ESMO, ASCO and IASLC. I actively participate in multidisciplinary conferences and case discussions with national and international colleagues. Recently, I took part in the IASLC Academy, which has been an incredible platform for international collaboration. There is a wealth of information to be shared globally, and much to be learned about the nuances that drive treatment decisions in different countries, according to patient and physician preferences and experience. Social media is another effective tool for sharing information and learning the latest advances in oncology.
From which particular congresses or studies would you like to have well-summarized information available quickly?
There are clinical scenarios where there is no one “right” answer, such as localized gastroesophageal junction cancer and the decision between chemotherapy and chemo-radiation, or early-stage lung cancer and a neoadjuvant or adjuvant treatment approach. In these situations, I would like to have quick access to well-summarized information and robust clinical data, so that I can best compare my patients to those enrolled in the different trials and base my decision in that way.
Which question about oncology do you get asked the most?
I most often get asked about work-life balance and “taking my work home.” As the wife of a surgeon and mother of three, putting my family first has been a key priority of mine while building my career. I believe we can pursue excellence professionally while maintaining a commitment to our own lives, and that when we take on roles that are fulfilling, we can find the time and enthusiasm to follow through on our goals.
“I look forward to the growth of the platform to incorporate epidemiology, etiology, screening and diagnosis. Climate change and its impact on human health is an issue that oncologists should be made aware of and serve as ambassadors to the medical community and society at large.”
Have you ever encountered ignorance about your work?
I find that there is ignorance about oncology in general, both among health professionals and those unrelated to medicine. Many consider oncology as pessimistic and mainly palliative, where in reality it is a dynamic field of innovation and hope. Lung cancer in particular is still stigmatized, but rather it has become the poster child of precision oncology and immunotherapy – and patients are living better and living longer than ever before. Even in cases of poor prognosis, accompanying patients and their families in difficult times is a humbling privilege. Cancer is a powerful word, and the public is not fully aware of what it entails.
How did you find out about Oncology Compass and how do you use this platform for your work at the Emek Medical Center?
I actually found out about Oncology Compass on social media. This platform has been an effective tool for me to read concise reports regarding the most relevant research. The site is well organized and intuitive to navigate. Importantly, it provides an unbiased filter for data on the issues that are pressing to us as oncologists, both in the clinic and for research. Staying up to date is a key pillar in our field, and in a world where information is constantly being sent to us, it is important to have a trustworthy platform to turn to.

Claraspital, Basel

Thomas Schmid is the Senior Physician Oncology/Haematology at the St. Claraspital in Basel. Opened in 1928 and privately run, the Claraspital covers an important part of healthcare in North-western Switzerland. The Claraspital tumour centre offers the complete oncological and haematological treatment panel, starting with diagnostics, through to curative and palliative therapies and rehabilitation.

The Claraspital is positioning itself as a DKG – certified centre for colon cancer, pancreatic cancer, esophageal cancer, breast cancer, kidney cancer and prostate cancer. It aims to support patients individually. A detailed oncological care concept was developed for this purpose.

Emek Medical Center, Afula

Ilit Turgeman is a medical oncologist focusing on thoracic and upper gastrointestinal cancers, and head of the early-onset cancer service at Emek Medical Center in Northern Israel (about 10 km outside Nazareth). The team of oncology professionals led by Professor Gil Bar-Sela is actively engaged in the planning of a new comprehensive centre for cancer care and research, “Beit Shulamit,” which will open mid-2023 and provide equitable and quality care for a large population in need.

They are working to end the persistent health disparities that exist in their country between individuals living in “central” and “peripheral” regions, as well as to incorporate integrative medicine in the treatment of their patients.
Interview with Sybille Holtkamp
Are Cancer Conferences vital to Improve Cancer Care?
Kristina Olujic
Interviewer, Medical Writer at Capptoo AG
It has become impossible for oncologists to cover cancer events that are organised around the world, or even try to attend the most important ones in person. Experts must ask themselves: How important are these events in the future, or rather, how fateful could it be to miss out on vital information?

Whether the inability to keep up with all of the most recent knowledge and results presented at the leading oncology conferences has a negative impact on clinical practice are questions that “Digest” asks Sybille Holtkamp, managing director of Medtoday Switzerland.
“Most oncologists probably don’t know the whole variety of events.” – Sybille Holtkamp
Based on what grounds do you make a selection on which conference you will showcase?
Often, doctors approach us because they have an idea for a new event and we create the concept, do the market research, try to raise the funding, and organise the event for them. In cancer care, we, of course, focus on the large conferences in the USA and Europe, such as ASCO and ESMO but also their specific conferences e.g. on GI. The selection of which medical conferences we cover is done by our scientific committees and chairs.
Sybille Holtkamp, managing director of Medtoday Switzerland
The scientific leaders of the Oncology Compass take part in webinars to discuss trials they have selected. Which of these webinars had the greatest impact?
In some webinars we reach 80 participants, in others only 30. It has become increasingly important to make the recordings available on-demand afterward. The interaction between the invited panellists and the participants is quite low in fully virtual programs. That is the biggest challenge of webinars. Some experts like to ask poll questions to the audience, but the participants rarely ask questions themselves or share their opinion.
Nowadays it seems every info is available online – why are actual physical events still needed?
True, information is available online. But the biggest challenge is to determine what is really newsworthy and important, what is practice-changing – and what is not. We focus on the discussion of important findings. It works in virtual meetings, but physical meetings are more natural. Also, the interaction is better at the location, between the experts and also between participants and experts. Speakers sometimes ask the audience to vote by raising their hand on a topic or treatment question or they address a colleague in the audience to give a short statement. That is not really possible in the webinar setting to that extent. Also, more people take the courage to ask questions or share their opinion.
How important is personal networking?
That’s actually the most important part. Exchanges with colleagues over a coffee on a patient, trial, or new drug, cannot be as casual in a virtual setting. And of course, meeting new people from other hospitals increases their network. A quick question to the pharma sponsor regarding a drug is only possible at physical events.
How important is the exchange of views between colleagues?
Let me give you an example. One of our experts is an expert in prostate cancer at a hospital. But he is the only expert in this field at this hospital. So, if he does not know how to proceed, no one in his institution can help him or the patient. Yet if he gets in touch with another prostate cancer specialist at another hospital, these two experts can evaluate options together. During office hours in a hospital or practice, this time is missing sometimes, so the casual meetings at events are also often used to discuss patient cases or to discuss a new drug and if a colleague has already used it.
Oncologists are pressed for time. How do they actually select which events they would want to participate in? How useful will it be to have a tool for selecting cancer events based on oncological interest?
Good question that we also try to evaluate. I think they base their selection on the day, time, invited experts, and access possibilities. During consulting hours they probably prefer a webinar or a location next door. Also, the topics and structure of the event play an important role. There is really a huge number of cancer events each year, so a tool could be really helpful for their selection.
What events do Oncologists seek out, which are the ones that must not be missed when it comes to ground-breaking new treatments or the latest findings?
Most oncologists probably do not know the whole variety of events. I think for Swiss oncologists the most important meetings are ASCO and ESMO, as they are the leading societies in cancer research. Most of the time, practice-changing results are presented at either of these congresses. But for specific cancer types, there are also other international congresses (i.e., SABCS, WCLC). Then there are many “Post-Events” that provide summaries of the most important findings.
What should a cancer conference provide to enable oncologists to stay up to date with the latest cancer trial findings while keeping the focus on patients?
Practical implications from a regional point of view. I think it is important that the experts highlight practice-changing studies and explain in a real case how they are going to change their treatment choice. Treatment might be different in different parts of Switzerland, so it is also important to break it down into different regions.
In your opinion, how do knowledge-sharing platforms such as the Oncology Compass impact and shape clinical practice today?
It’s hard to say. I think Covid changed a lot and opened new ways for knowledge-sharing but the movement is not finished yet. The difficult part is, how to select and retrieve the relevant information.
“The difficult part is, how to select and retrieve the relevant information.” – Sybille Holtkamp
Medtoday Switzerland specializes in the organization and set-up of on-site, hybrid, and fully virtual medical education events. Every year, the agency organizes more than 30 events in oncology and other entities such as rheumatology, urology, and gastroenterology, ranging from a 1-hour webinar to a 3-day on-site conference. The company is based in Kilchberg, Zurich.
User Data

Platform Stats in Q4 2022

13 Scientific Leaders
selected practice-relevant publications for lung, renal, gastro-esophageal and melanoma cancer.

+153

New users since January 2022

The number of oncologists using the platform continues to grow.

235

Total active users on the Platform

We are proud that Oncology Compass is becoming an increasingly important tool for oncologists.
Website Visitors
7200+
Pageviews
30800+
Sessions
11200+
Avg. Session
2,39
Avg. Session Duration per Registered User
6,22 min
Pages per Session per Registered User
11,4
Insights: website visitors
users by DEVICES
device category
total users
pageviews
sessions
Desktop
3,258
20,364
5,924
Mobile
2,231
4,076
2,704
Tablet
177
267
191
Users by place of work
Need specific audience data?
Our data analysts will do their best to make it happen.
Contact Marija Galić for more info.
Top 10 countries where visitors come from
country
users
1. Netherlands
1,365
2. Switzerland
1,205
3. United States
680
4. India
551
5. United Kingdom
486
6. Germany
465
7. Belgium
170
8. France
137
9. Italy
133
10. Austria
93
users by age *
age group
users
1. 25-34
548
2. 35-44
431
3. 18-24
400
4. 45-54
366
5. 55-64
305
10. 65+
243
Users by gender *
912
Female
855
Male
* for the rest of visitors, the gender and age are unknown, they choose not to share it.
news
Dr. Jacob Berchuck, Medical Oncologist at the Lank Center for Genitourinary Oncology, Dana-Farber Brigham Cancer Center, Boston.
breakthrough

Game-Changer for Prostate Cancer?

According to Dr. Jacob Berchuck, the CABASTY phase III trial could change the way we will look at prostate cancer.

Dr. Jacob Berchuck, a Medical Oncologist at Dana-Farber Brigham Cancer Center's Lank Centre for Genitourinary Oncology, selected and categorized the most recent prostate cancer studies presented at ESMO 2022 based on their relevance to oncology practice. He described the CABASTY trial as “a game-changer for a selected population of prostate cancer patients”.

The findings of the RADICALS-HD study were considered promising by Dr. Berchuck, who named this trial a "potentially practice-changing trial." The STAMPEDE trial platform and the PEACE-1 phase III trial were assessed as "practice-informing trials". The CABASTY trial was highlighted as "a game changer for a subcategory of prostate cancer patients."

The CABASTY phase III trial showed that administering 16 mg/m2 cabazitaxel every 2 weeks induces less grade ≥3 neutropenia and/or neutropenic complications compared to 25 mg/m2 cabazitaxel every 3 weeks in older patients with mCRPC. These findings suggested that 16 mg/m2 cabazitaxel every 2 weeks should be used in the case of elderly mCRPC patients who are unable to receive 25 mg/m2 cabazitaxel every 3 weeks.
“Cabazitaxel every 2 weeks for frail patients is something that I would consider for that population in my clinic.” – Dr. Jacob Berchuck
breakthrough

Whole-genome Sequencing within Reach for Clinical Diagnostics in Oncology

In the coming era of personalised medicine and with the rapidly expanding tableau of targeted therapies, genome-driven cancer care has become the cornerstone of modern precision oncology. Many fascinating studies have recently been published in the area of genomics and oncology. Ven et al investigated a possible future use of whole-genome sequencing in clinical practice showing that the implementation of whole-genome sequencing depends on the price, clinical utility, and turnaround time. Not long ago, Tarpey et al confirmed for the paediatric population that whole-genome sequencing gives a more accurate diagnosis and reveals new treatment options.

One of the advantages of whole-genome sequencing is that it allows researchers to look into the entire tumour DNA of the patient, regardless of tumour type. This makes it possible to identify DNA errors that can be treated but that are normally not looked for in standard diagnostics. With whole-genome sequencing, there is no preselection, making this test very objective. In January 2021, the Netherlands Cancer Institute became the first hospital in the Netherlands to include whole-genome sequencing in regular diagnostics for specific indications based on the results of the WIDE study.

Cancer whole-genome sequencing with next-generation sequencing is used in oncology to select the optimal treatment and to prevent over-treatment. Whole-genome sequencing detects unique mutations present in cancer tissue and therefore enables discovery of novel cancer-associated biomarkers. The test is reliable and even guides the diagnosis of patients with metastatic cancers. This puts whole-genome sequencing within reach for physicians and patients in regular oncological care. In the coming years, the growing amount of genetic information will most probably change the outcomes for many cancer types.
Dr. Jarushka Naidoo (middle) attending the Lung Cancer Summit 2022. She is a thoracic oncologist specializing in immunotherapy for lung cancer at the Beaumont RCSI Cancer Centre, Dublin.
NSCLC updates

Where do Combination Therapies Make Sense for Advanced NSCLC – and where not?

During the International Lung Cancer Summit 2022, Dr. Jarushka Naidoo posed the important question about future treatments for advanced NSCLC: Where and when do combination therapies make sense?

Dr. Jarushka Naidoo, Medical Oncologist at Beaumont Hospital Dublin, held a presentation “Immunotherapies in good company: Where do combination therapies make sense in advanced NSCLC – and where not?” which discussed the effects and advancements of immunotherapies in NSCLC.

Dr. Naidoo presented and discussed the five-year outcomes of the chemotherapy plus immunotherapy trials that formed clinical practice. She concluded that combinations make sense when immunotherapy and chemotherapy, with or without an anti-angiogenic agent, lead to durable responses and long-term survival, and when the toxicity profile of the combination is similar to that of chemotherapy alone.

In addition, the oncologist described groups of NSCLC patients for whom combination therapies may not be the right treatment approach. Combinations, according to Dr. Naidoo, do not make sense when a similar benefit may be derived from PD-L1 monotherapy, including PD-L1 >50% population, platinum-ineligible population, and potentially ECOG PS2, as well as when toxicity has a synergistic effect and can be fatal.
“The durability of response, long-term survival, improved tolerability, and improved quality of life make immuno-therapy distinct and more unique from targeted and systematic therapy.” – Dr. Jarushka Naidoo
Dr. Stephen V. Liu, Associate Professor of Medicine, Director of Thoracic Oncology and Director of Developmental Therapeutics, at the Lombardi Comprehensive Cancer Center of Georgetown University, Washington.
SCLC updates

What are the Current First-line Options for SCLC Patients?

The Oncology Compass took part at the International Lung Cancer Summit 2022, which showcased the most recent lung cancer discoveries and advances. During the conference, Dr. Stephen V. Liu posed an intriguing question for SCLC: “What are our options today in the first line?”

Dr. Stephen V. Liu, an Associate Professor of Medicine at Georgetown University, delivered a keynote speech titled “SCLC: What are our options in first-line today?” in which he discussed the advantages and limitations of current treatment options for SCLC patients. He defined small cell lung cancer (SCLC) as a systemic disease that responds temporarily to cytotoxic therapy but still is lethal upon relapse.

Dr. Liu discussed the integration of checkpoint inhibitors into lung cancer treatments. "What we learnt over the past decade is that immunotherapy is active in SCLC, but that activity is modest in an unselected population.”, the oncologist concluded. He referred to the IMpower133 trial as the first in four years to show an improvement in survival in patients with advanced-stage SCLC.

In March 2020, the FDA approved durvalumab plus platinum or etoposide as first-line therapy for advanced SCLC based on the findings of the CASPIAN study.
“When we add checkpoint inhibitors to front-line chemo-therapy there is a modest but significant improvement in survival.” – Dr. Stephen V. Liu

Thank you & see you in April!

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Oncology Compass is a service of Capptoo for physicians. The information contained therein reflects the independent opinion, expertise and experience of the scientific board. This view is not necessarily that of Capptoo.

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